Soluble Hepatocyte Growth Factor (sHGF) and Vascular Endothelial Growth Factor (sVEGF) in Adult Acute Myeloid Leukemia: Relationship to Disease Characteristics

Abstract

There is little understanding of the factors controlling the mobilization of blast cells from bone marrow to peripheral blood and tissues. The aim of this study was to evaluate the soluble hepatocyte growth factor (sHGF) and vascular endothelial growth factor (sVEGF) levels in newly diagnosed patients with acute myeloid leukemia (AML) and to correlate these levels with the clinico-pathological features. Sixty-three patients with AML and 15 normal controls were included in this study. The levels of sHGF and sVEGF were determined by enzyme linked immunosorbent assay at diagnosis and after remission induction chemotherapy. Our results revealed significantly increased plasma levels of sHGF and sVEGF at diagnosis when compared to both control and remission levels (P=0.000 for both). The sHGF and sVEGF levels differed between AML FAB subtypes (P=0.000). The highest concentrations were found in M5 followed by M4. SHGF and sVEGF were directly correlated with peripheral white cell counts (WBC) (r=0.836, P=0.000, r=0.718; P=0.000, respectively), but inversely correlated with blast cell distribution ratio (BCDR) (r=−0.785, P=0.000, r=−0.664, P=0.000, respectively). Moreover, both sHGF and sVEGF levels were significantly elevated in AML patients with extra-medullary infiltration as compared to those without (P=0.000, 0.006, respectively). The sHGF but not sVEGF levels were significantly elevated in patients who died compared to those who relapsed and to patients in complete remission (P=0.02, 0.08, respectively). Logistic regression analysis revealed that the sHGF level at diagnoses is a powerful predictor of the patient outcome, compared to sVEGF.

In conclusion: our data support the hypothesis that angiogenic factors play a functional role in blast cell movement from the bone marrow to peripheral tissues. Assessment of sHGF at AML diagnosis is likely to be helpful in predicting patient outcome and selecting optimal therapeutic regimen.

Keywords:

• Acute myeloid leukemia
• Angiogenic growth factors
• HGF
• VEGF
• Prognosis